When Rebecca Santucci of Lakewood learned that her sister, Stacy, had been exposed to COVID-19, she set out in search of a rapid test. She quickly wanted to know if her 88-year-old father was in danger.
Pharmacies were wiped out with home testing kits, and testing clinics were solidly booked for at least two weeks. On Amazon, she found a set of two at-home tests for $38, but they won’t arrive until next month. And anything that requires waiting hours in line won’t work for her sister, who has Down syndrome and anxiety.
Eventually she found a slot for a rapid antigen test at a private drive-thru clinic on the website of the city’s Lakewood. But it happened five days after Stacy found out about her potential performance.
Price tag for trial: $129.
“We ended up paying the money but killed me for doing so,” Rebecca said. Stacy tested negative, so at least she finally found peace of mind.
With the explosion of the highly permeable Omicron variant, more Californians find themselves looking for tests wherever they can find them. State and local testing sites offer free COVID-19 tests, but they are bogged down, forcing people to turn to private pop-up clinics.
Quick results often come with a hefty upfront cost: Some clinics charge around $300 for a rapid PCR test.
Although state and federal regulations require that COVID tests be free or covered by health insurance, people often have to pay upfront, and that amount is not affordable for many Californians.
Those who can’t pay often have to wait in line for hours at local and state free testing sites, and then sometimes for several days for lab results.
“There is a requirement that the test be free, but there is no requirement for how fast those test results need to be returned,” said Shira Shafir, a UCLA professor of epidemiology. “With this omicron boom, some people are again waiting four to five days for those lab results and at that point those results are essentially useless.”
Adding to the demand for quick results is that some places demand proof of testing within a time frame of 24 to 72 hours. People need them to visit nursing and senior homes, return to daycare programs, or fly to Hawaii or abroad.
Pop-up sites at California’s international airports charge an upfront fee. At San Francisco International Airport, the rapid test costs $275. At Los Angeles International Airport, a rapid PCR test costs $199 with results in one hour. According to one LAX provider, Clarity Mobile Venture, debit or credit card payment is required, although a receipt is provided for insurance reimbursement. At San Diego International Airport, the cost is $135 to $165, and at Long Beach Airport, a test with 1.5-hour results costs $250.
At the Lakewood clinic where Santucci went, costs range from $129 for a rapid antigen test with one-hour results to $299 for a PCR test with two-hour results. The clinic also advertises a free standard PCR test with results in two or more days.
“With rapid tests, what people are paying for is a guarantee of quick results,” Shafir said. “The test site isn’t always pitching it that way.”
Both PCR and antigen testing are used to diagnose COVID-19; Antigen tests can give faster results but PCR tests are more sensitive to detect the virus so they are considered more accurate.
Health experts say getting results early is important to protect people and avoid prolonged quarantines, but rapid tests have long been in short supply.
save your receipts
Californians have many places where they can be tested: pharmacies, community clinics, government mass-testing sites, and private pop-up sites. Many of these are free, but they are booked for weeks. Some pop-up testing sites charge an upfront fee, leading to confusion as to why, as the trial is supposed to be free.
In most pharmacies and doctor offices, providers do not charge people directly. Instead, they collect insurance information so that they can be paid. But some private testing clinics charge individuals, who are then responsible for receiving reimbursement from an insurer. Claims can be filed online or sent to the insurer by mail.
But it is not always a guarantee that they will get their money back.
Stacey Santucci is covered by Medicare, which covers people with disabilities. Rebecca said she didn’t receive a receipt after her sister’s test, but did get an email confirmation from the testing provider, COVID Clinic. When Rebecca called her sister’s Medicare plan, she was advised to print the email and send it by snail mail, but there was no assurance she would be reimbursed because the printed email may not be sufficient.
Experts recommend checking receipts for additional service charges, such as charges for quick results.
It’s misleading to charge an extra fee for speedy results, said state Sen. Richard Pan, a Democrat from Sacramento who wrote SB 510, a bill last year that clarified the rules for free testing. The law, which took effect January 1, codifies federal rules into state law, which requires insurance companies to cover testing without cost sharing such as copays or deductibles.
Pan said his office is looking into the cases of providers who are facing additional charges for a test — they’ll provide a procedure code for the test, which patients can submit to their insurer for repayment, But they will not provide reimbursement codes for mysterious additional charges.
“An attempt is being made to divide the bill in such a way that it continues to cause harm to the patient, is certainly not in the spirit of the law,” Pan said.
The law also does not address the issue of making advance payments. The challenge is that new testing sites usually don’t have existing relationships with insurers, so instead they charge in person, Pan said.
“They (testing clinics) just want to get paid, no matter where the payment comes from,” Shafir said.
It has been a pattern during the pandemic that those with fewer resources are less likely to have access to testing.
Experts say upfront costs and long lines could deter people from getting tested and increase health disparities. People without insurance do not have the option of receiving reimbursement. And the test requires free time or a flexible job, and sometimes the physical ability to stand in line or own a car.
State reviewing complaints
The California Department of Public Health told CalMatters in an unsigned email that it is aware of complaints about the pop-up sites, including concerns about business practices related to pricing, but also the legality of testing and sample handling. Is.
The Department of Health urges residents to look for verified testing sites on its website with no out-of-pocket costs, regardless of their insurance status.
In a recent press conference, Governor Gavin Newsom discussed the more than 6,200 verified testing locations in the state. According to the state health department, about 90% of Californians are within a 30-minute drive from a verified testing site.
“While this is impressive, we believe it is not good enough, nor is the fact that lines are visible at sites like this across the state,” Newsom said Wednesday from a testing location at Paramount.
In response, Newsom has tapped the National Guard to help administer the test and introduced a $2.7 billion COVID relief package that includes dollars to increase capacity, staffing and hours at testing sites, as well as send Including expanding the number of ongoing COVID-19 antigen tests. Local health departments, community clinics and county offices of education and schools.
Testing sites are likely to be in high demand for several more weeks, especially with at-home testing kits still hard to come by.
For those who can get tested at home, a new state order will add some protection to their payments. Newsom signed an executive order to protect people from rising prices of at-home testing kits. The order prohibits the sale of test kits on December 1 at a price not exceeding 10% of the price being charged by the seller. New sellers cannot charge more than 50% of the price paid for the test kit.
Starting Saturday, a new federal rule will allow people who purchase at-home tests, up to eight at-home coronavirus tests per person per month, to receive reimbursement from their insurer. Again, the trick is finding those tests.